ShoeGuy: A New Slant on Pronation

The Biomechanical Theory Behind Orthotics

It's always nice when the readers write, especially a reader who’s right. And so it was when one Stacy Osborne, DPM, took keyboard in hand to respond to ShoeGuy’s answer to a question from the "Flowers & Flames" page in the September issue of this esteemed running publication.

"J.D. Denton’s answer to a reader’s question concerning orthotics is a little off base when he replied, ‘The orthotic itself doesn’t address the degree or velocity of over-pronation.’"

It’s nice that he accused me of only being "a little off base." Obviously, he’s never had a conversation with my brother-in-law, or he would know some consider me to be decidedly way off base.

"It has been demonstrated that running shoes and orthotics both can and do affect the rate or velocity of pronation."

The key word there is "both." Of course both shoes and orthotics work. Otherwise, why would millions of savvy runners invest so much time and credit card liability in both? ShoeGuy should have more clearly made his point by saying the orthotic "alone" doesn’t address the degree and velocity of over-pronation. Orthotics, amazing as they may be, need shoes that work with them.

The reader who started this mess, a Bruce Mihalick writing from cyber-land, simply wanted to know if he should continue to wear stability shoes with his new orthotics (as approved by his podiatrist), or could he now wear neutral shoes, assuming that the orthotics would do all of the correction needed.

My experience is that shoes used with orthotics should address the same issues said orthotics were designed to correct. An orthotic made to correct over-pronation, for example, is best supported in a shoe that does the same. Otherwise, both the foot and the orthotic may over-pronate together in a soft, flexible neutral shoe.

Doc Stacy, however, departed from the shoe-working-with-orthotic discussion and proceeded to do a mini-clinic on biomechanics:

"The human foot is designed to do five things when running: Make contact with the ground, absorb shock from the ground, adapt to the ground, lock onto the ground and propulse (sic) off the ground."

Sounds like a description on a Pentagon purchase order. There’s a lot going on down there, which is as good an excuse as any for those of us who run slowly. We’re just giving our feet enough time to contact, absorb, adapt, lock and propel.

"It has been my experience that the most common biomechanical fault that causes injuries is in phase two; if the runner’s foot spends too much time in the shock absorbing phase then every biological structure in the foot, ankle, shin, knee, thigh and hip has to work harder in phases three, four and five."